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Trachoma control in two Central Australian Aboriginal communities: a case study.
Van C Lansingh1, Bickol N Mukesh, Jill E Keeffe
1Centre for Eye Research Australia, University of Melbourne, East Melbourne, VIC, Australia. vlansingh@v2020la.org
International Ophthalmology
|April 2, 2010
Summary
The SAFE strategy, including Azithromycin and facial cleanliness promotion, significantly reduced trachoma in Australian Aboriginal communities. Environmental improvements showed no additional benefit, possibly due to confounding factors.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Environmental Health
Background:
- Trachoma remains a significant public health issue, particularly in remote Aboriginal communities in Australia.
- The SAFE strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvements) is the recommended approach for trachoma control.
- The specific impact of environmental improvements (E) within the SAFE strategy requires further assessment.
Purpose of the Study:
- To evaluate the additional impact of environmental changes (E) on trachoma control within the broader SAFE strategy.
- To compare trachoma prevalence and facial cleanliness in communities with and without environmental improvements.
- To assess the effectiveness of Azithromycin distribution and facial cleanliness promotion.
Main Methods:
- A prospective case study was conducted in two Aboriginal communities in Central Australia.
- Baseline data on trachoma, facial cleanliness, and nasal discharge were collected from children under 15.
- Interventions included health promotion, facial cleanliness promotion, housing/environmental improvements in one community, and Azithromycin distribution to all residents.
Main Results:
- Baseline trachoma rates were comparable between the two communities (48% and 50%).
- Trachoma prevalence significantly decreased at 3, 6, and 12 months post-intervention in both communities.
- No significant difference in trachoma reduction was observed between the community receiving environmental improvements and the control community.
Conclusions:
- The Azithromycin and Facial cleanliness (A/F) components of the SAFE strategy were effective in reducing trachoma prevalence.
- Environmental improvements (E) did not demonstrate an additional benefit in this study, potentially due to masking factors.
- Further research is needed to understand the role of environmental factors in trachoma control in similar settings.
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